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Emergency nurses’ decisions regarding frequency and nature of vital sign assessment

Version 2 2024-06-03, 23:54
Version 1 2016-11-16, 14:23
journal contribution
posted on 2024-06-03, 23:54 authored by K Lambe, Judy CurreyJudy Currey, Julie ConsidineJulie Considine
AIMS AND OBJECTIVES: To explore the factors emergency nurses use to inform their decisions regarding frequency and nature of vital sign assessment. BACKGROUND: Research related to clinical deterioration and vital sign assessment in the emergency department is in its infancy. Studies to date have explored the frequency of vital sign assessment in the emergency department; however, there are no published studies that have examined factors that emergency nurses use to inform their decisions regarding frequency and nature of ongoing vital sign assessment. DESIGN: A prospective exploratory design was used. Data were collected using a survey consisting of eight patient vignettes. METHODS: The study was conducted in one emergency department in metropolitan Melbourne. Participants were emergency nurses permanently employed at the study site. RESULTS: A 96% response rate was achieved (n=47/49). The most common frequency of patient reassessment nominated by participants was 15 or 30 minutely, with an equal number of participants choosing these frequency intervals. Abnormality in initial vital sign parameters was the most common factor identified for choosing either a 15 or 30 minute assessment interval. Frequency of assessment decisions were influenced by years of emergency nursing experience in one vignette and level of postgraduate qualification in three vignettes. Heart rate, respiratory rate and blood pressure were all nominated by over 80% of participants as vital signs that participants considered important for reassessment. The frequency and nature of vital signs selected varied according to vignette content. There were significant negative correlations between assessment of conscious state and years of nursing experience and assessment of respiratory rate and years of emergency nursing experience. Level of postgraduate qualification did not influence selection of parameters for reassessment. CONCLUSION: Emergency nurses are tailoring vital sign assessment to patients' clinical status and nurses are integrating known vital sign data into vital sign decision making.

History

Journal

Journal of Clinical Nursing

Volume

26

Pagination

1949-1959

Location

England

ISSN

0962-1067

eISSN

1365-2702

Language

English

Publication classification

C Journal article, C1 Refereed article in a scholarly journal

Copyright notice

2016, Wiley

Issue

13-14

Publisher

WILEY